A total ear canal ablation (TECA) is performed when infectious/inflammatory ear canal disease has advanced to the extent that it cannot be managed medically or in the face of a tumor involving the ear canal.
Most commonly, this procedure is performed for management of end-stage infectious/inflammatory ear canal disease. Patients with such ear disease have thickened, very painful ear canals. In response to the chronic inflammation precipitated by the infection, the ear canals can actually be converted to bone. When this happens, there is nothing medically that can be done to treat this. As such, the most appropriate course of action is to remove the entire ear canal. The pinna or “floppy” part of the ear is NOT removed so these patients can actually look fairly normal cosmetically.
An incision is made directly over the ear canal just below the opening. Another incision is made around the opening of the canal. The soft tissues are carefully dissected from the ear canal all the way to the skull. Once the dissection has been carried to the skull, the ear canal is amputated and removed. The middle ear chamber is then opened and its epithelial lining is removed. The surgery site is then flushed with sterile saline and a special catheter called a soaker catheter is then inserted into the surgery site and the surgical approach is then closed with suture material. Local anesthetic can then be delivered directly to the surgery site in a very controlled fashion through the soaker catheter. This is instrumental in managing post-operative discomfort.
Potential complications associated with this procedure include but are not limited to infection, facial nerve paralysis (usually temporary but can be permanent), head tilt or vertigo (usually temporary but can be permanent) and the development of a chronic draining tract due to the presence of a retained piece of epithelial lining material in the middle ear. The incidence of permanent complications is low. None of the potential complications precludes me from recommending this procedure in patients that warrant it. In my opinion, this is one of the very best procedures that can be performed in veterinary surgery. In the vast majority of patients, it brings to an end years of chronic discomfort and odor. It gives these patients a new lease on life.
Will this procedure make my pet deaf?
Patients that have end-stage ear disease are likely severely hearing impaired owing to their severe ear disease. Removing the painful ear canals is unlikely to make their hearing worse. They do seem to be able to sense vibrations after the surgery and I have had some pet owners tell me that their pets actually hear better after the procedure. It is unlikely that their hearing has improved. Their new responses to sounds are probably a reflection of the fact that they can pay attention to other things once their ears stop hurting. We do not have reliable methods to help us determine exactly how acutely they can hear pre-operatively versus post-operatively.